ACCESSORY DIGESTIVE

ORGANS
DID YOU
KNOW?
Teeth are also part of the digestive
system and are essential for breaking
down food before swallowing.

They are made up of four types of

tissue: enamel, dentin, pulp, and
cementum.
Enamel is the hardest substance in the
hydroxyapatite crystals that are 1000
human body and is the protective
times larger than those found in bone.
outer layer of teeth.
 PARTS OF TOOTH
CROWN
The enamel-covered crown is the exposed part of the
tooth above the gingiva or gum.

ENAMEL
Is the hardest substance in the body and is fairly
brittle because it is heavily mineralized with calcium
salts.

ROOT
The outer surface of the root is covered by a substance
called cementum, which attaches the tooth to the
periodontal membrane (ligament).
DIFFERENCE OF PLAQUE AND TARTAR

PLAQUE TARTAR

Tartar is hardened plaque or

Plaque is a soft, colorless film of
hard and crusty that makes
bacteria that forms on teeth
teeth appear discolored
DECIDUOUS TEETH PERMANENT TEETH

Also known as baby teeth or milk They are the second set of teeth
teeth
the roots of the milk teeth are
they begin to erupt around 6 months reabsorbed

A baby has a full set (20 teeth) by the between the ages of 6 to 12 years they
age of 2 years. loosen and fall out.
BABY TEETH AND PERMANENT
TEETH

if the baby tooth is left too long, it can

cause gum inflammation and impede
the eruption of the adult tooth.
 MATCHING TYPE:

INCISORS a.

CANINES b.

PREMOLARS
(BICUSPID) c.

MOLARS d.
INCISORS
Are flat and thin, and they slice through food
when you take a bite.

Deciduous tooth
Erruption time : 6-12 Months Old

Permanent tooth
Erruption time : 6-8 Years Old
 CANINES
The fanglike canines are for tearing and
piercing.

Deciduous tooth
Erruption time : 16-23 Months Old

Permanent tooth
Erruption time : 8-12 Years Old
PREMOLARS & PRE-MOLAR
MOLARS (bicuspid)

Molars: used to grind food

Premolars: used to crush and grind food.

Adults have four premolars on each side of their

mouth, or eight premolars in total.

Most adults have 12 molars, eight premolars, four

canines, and eight incisors
SALIVARY GLANDS
SALIVARY GLANDS MAKE SALIVA TO HELP WITH
CHEWING AND DIGESTING FOOD.
DID YOU
KNOW?
Adults produce about 1–2 liters of saliva
every day and can fill a tub in one year

Saliva helps you taste food, starts the

digestive process, and repairs teeth.

The majority of saliva is produced in the late

afternoon, and the least amount is produced
in the evening.
DID YOU
KNOW?
Adults produce about 1–2 liters of saliva
every day and can fill a tub in one year

Saliva helps you taste food, starts the

digestive process, and repairs teeth.

The majority of saliva is produced in the late

afternoon, and the least amount is produced
in the evening.

BUT WHY?
BUT WHY?
The salivation acts essentially to assist in the
beginning parts of the digestive system;
chewing, swallowing, and moving the
chewed food down the throat into the
stomach

Saliva not only helps lubricate food for easier

swallowing but also contains enzymes, such
as amylase, that begin breaking down
carbohydrates.

Electrolytes
SALIVARY GLANDS 1 . PAROTID GLANDS
The parotid glands are two salivary glands that sit
just in front of the ears.

2. SUBMANDIBULAR & SUBLINGUAL GLANDS.

Empty their secretions into the floor of the mouth
through tiny ducts.

3. SALIVA
The product of the salivary glands, saliva, is a
mixture of mucus and serous fluids.

3. SALIVARY AMYLASE.
The clear serous portion contains an enzyme,
salivary amylase, in a bicarbonate-rich juice that
begins the process of starch
digestion in the mouth.
SALIVARY GLANDS 1 . PAROTID GLANDS
The parotid glands are two salivary glands that sit
just in front of the ears.

largest of the salivary glands

primarily produces serous saliva

Saliva produced by the parotid gland travels

through the parotid duct (Stensen's duct)
and enters the oral cavity

FUNCTION
secrete saliva that aids in the initial stages of
digestion by breaking down carbohydrates into
simpler sugars. It also helps lubricate the food for
easier swallowing.
SALIVARY GLANDS 2. SUBMANDIBULAR GLANDS
Empty their secretions into the floor of the mouth
through tiny ducts.

produces mucous saliva, which is thicker and

more viscous than the serous saliva

initiate the formation of the bolus (a ball of

food) during chewing.

FUNCTION
lubrication of the oral cavity and aids in the initial
stages of digestion by moistening the food and
forming the bolus.
SALIVARY GLANDS 3. SUBLINGUAL GLANDS
located beneath the floor of the mouth, near the
lower jawbone.

a mixed gland, containing both serous and

mucous acini (clusters of secretory cells)

larger than the sublingual gland but smaller

than the parotid gland.
Saliva from the submandibular gland is
drained into the oral cavity through the
submandibular duct (Wharton's duct), which
opens on either side of the frenulum (a small
fold of tissue) under the tongue.

FUNCTION
It produces a significant portion of the saliva in
the oral cavity and helps initiate the breakdown
of carbohydrates.
MINOR SALIVARY
GLANDS
There are hundreds of minor salivary glands
throughout the mouth and the aerodigestive
tract

too small to be seen without a microscope

found in the lining of the lips, the tongue,

and the roof of the mouth, as well as inside
the cheeks, nose, sinuses, and larynx (voice
box).
 PANCREAS
ONLY THE PANCREAS PRODUCES ENZYMES THAT BREAK DOWN ALL
CATEGORIES OF DIGESTIBLE
FOODS.
PANCREAS

The pancreas is a gland in the abdomen that's part of both the

digestive system and the endocrine system. It's about the size
of a hand and is located behind the stomach, across the back
of the belly.

The pancreatic enzymes are secreted into the

duodenum in an alkaline fluid that neutralizes the acidic
chyme coming in from the stomach.
PANCREAS
EXOCRINE FUNCTION
Produce digestive enzymes : acinar cells

release bicarbonate: neutralizes the acid from the

stomach

Pancreatic AmylaseBeta Cells (Insulin):

Trypsin, Chymotrypsin, and Carboxypeptidase:
Pancreatic Lipase:

ENDOCRINE FUNCTION

produce hormones : small clusters of endocrine cells

called The Islets of Langerhans:

Alpha Cells (Glucagon)

Beta Cells (Insulin):
Delta Cells (Somatostatin):
ISLETS OF LANGERHANS
Beta cells secrete insulin id glucose blood sugar goes
high and facilitates glucose uptake in cells throughout
body

Alpha cells secrete glucagon to raise blood sugar ny

stimulating liver to release stored glucose =
gluconeogenesis

Delta cells secrete somastosin, it releases both insuin

and glucagon for glucose homeostasis

Alpha Delta Beta

cell cell cell
secrete secrete secrete
glucagon somastosin insulin
LIVER
.....
LIVER
THE LIVER IS THE LARGEST GLAND IN THE BODY.

Location. Located under the diaphragm, more to the right side of

the body, it overlies and almost completely covers the stomach.
Function. The liver’s digestive function is to produce bile.

BILE
Bile is a yellow-to-green, watery solution containing bile
salts, bile pigments, cholesterol, phospholipids, and a
variety of electrolytes.

BILE SALTS
Bile salts. Bile does not contain enzymes but its bile salts
emulsify fats providing more surface area for the fat-
digesting enzymes to work on.
 a primary component of bile and are needed by the body
to help break down fats, aid digestion, absorb important
vitamins, and eliminate toxins. Bile salts are stored in your
gallbladder when they're not being used.
 Location. The gallbladder is a small, thin-walled green sac that

GALLBLADDER snuggles in a shallow fossa in the inferior surface of the liver.

ITS MAIN FUNCTION IS TO STORE BILE

CYSTIC DUCT
When food digestion is not occurring, bile backs up the
cystic duct and enters the gallbladder to be stored.
PHYSIOLOGY OF THE
DIGESTIVE SYSTEM
Activities that occur in the mouth,
pharynx, and esophagus are:
food ingestion
food breakdown
and food propulsion.
FOOD INGESTION AND BREAKDOWN
ONCE FOOD IS PLACED IN THE MOUTH, BOTH
MECHANICAL AND CHEMICAL DIGESTION BEGIN.

STIMULATION OF SALIVA When food

PHYSICAL BREAKDOWN First, the
food is physically broken down into
smaller particles by chewing.
enters the mouth, much larger amounts
of saliva pour out; however, the simple
pressure of anything put into the
mouth and chewed will also stimulate
the release of saliva.

CHEMICAL BREAKDOWN Then, as

the food is mixed with saliva, salivary
amylase begins the chemical
digestion of starch, breaking it down
into maltose.
FOOD PROPULSION – SWALLOWING
AND PERISTALSIS

DEGLUTITION
Deglutition, or swallowing, is a complex process that involves the coordinated
activity of several structures
(tongue, soft palate, pharynx, and esophagus).

3 PHASES, NAMELY:
THE VOLUNTARY BUCCAL PHASE
PHARYNGEAL PHASE
ESOPHAGEAL PHASE
For food to be sent on its way to the
mouth, it must first be swallowed.
 1. BUCCAL PHASE OF DEGLUTITION.
The first phase, the voluntary buccal phase, occurs in the mouth; once the
food has been chewed and well mixed with saliva, the bolus (food mass) is
forced into the pharynx by the tongue.
 2. PHARYNGEAL PHASE
the involuntary movement of the bolus from the oropharynx into the esophagus
 3. ESOPHAGEAL PHASE
involuntary movement of the bolus through the esophagus and into the stomach
The activities of the stomach involve
food breakdown
food propulsion
ACTIVITIES OF THE STOMACH

FOOD BREAKDOWN
Food entry. As food enters and fills
the stomach, its wall begins to
stretch (at the same time as the
gastric juices are being secreted).
Stomach wall activation. Then the
three muscle layers of the stomach wall
become active; they compress and
pummel the food, breaking it apart
physically, all the while continuously
mixing the food with the enzyme-
containing gastric juice so that the
semifluid chyme is formed.
ACTIVITIES OF THE STOMACH

The sight, smell, and taste of food stimulate parasympathetic nervous system
reflexes, which increase the secretion of gastric juice by the stomach glands

Gastric juice. Secretion of gastric juice is regulated by both

neural and hormonal factors.
Gastrin. The presence of food and a rising pH in the stomach
stimulate the stomach cells to release the hormone gastrin
Pepsinogen. The extremely acidic environment that hydrochloric
acid provides is necessary, because it activates pepsinogen to
pepsin, the active protein-digesting enzyme.
Rennin. is second protein-digesting enzyme produced by the
stomach, works primarily on milk protein and converts it to a
substance that looks like sour milk.
FOOD PROPULSION
Peristalsis is responsible for the movement of food towards the
digestive site until the intestines.

Peristalsis. Once the food has been well mixed, a rippling peristalsis
begins in the upper half of the stomach, and the contractions increase
in force as the food approaches the pyloric valve.

Pyloric passage. The pylorus of the stomach, which holds about 30 ml

ofchyme, acts like a meter that allows only liquids and very small
particles to pass through the pyloric sphincter;

Enterogastric reflex. When the duodenum is filled with chyme and its
wall is stretched, a nervous reflex, the enterogastric reflex, occurs; this
reflex “puts the brakes on” gastric activity and slows the emptying of
the stomach by inhibiting the vagus nerves and tightening the pyloric
sphincter, thus allowing time for intestinal processing to catch up.
FOOD BREAKDOWN AND ABSORPTION
Food reaching the small intestine is only partially digested.

Digestion. Food reaching the small intestine is only partially digested;

carbohydrate and protein digestion has begun, but virtually no fats have been
digested up to this point.
Brush border enzymes. The microvilli of small intestine cells bears a few
important enzymes, the so-called brush border enzymes, that break down
double sugars into simple sugars and complete protein digestion.

Pancreatic juice. Foods entering the small intestine are literally deluged with
enzyme-rich pancreatic juice ducted in from the pancreas, as well as bile from
the liver; pancreatic juice contains enzymes that, along with brush border
enzymes, complete the digestion of starch, carry out about half of the
protein digestion, and are totally responsible for fat digestion and digestion of
nucleic acids.
FOOD BREAKDOWN AND ABSORPTION

Chyme stimulation. When chyme enters the small intestine, it stimulates the
mucosa cells to produce several hormones; two of these are secretin and
cholecystokinin which influence the release of pancreatic juice and bile.

Absorption. Absorption of water and of the end products of digestion occurs

all along the length of the small intestine; most substances are absorbed
through the intestinal cell plasma membranes by the process

Diffusion. Lipids or fats are absorbed passively by the process of diffusion.

Debris. At the end of the ileum, all that remains are some water, indigestible
food materials, and large amounts of bacteria; this debris enters the large
intestine through the ileocecal valve.
FOOD PROPULSION
Peristalsis is the major means of propelling food through the digestive tract.

Peristalsis. The net effect is that the food is moved through the small
intestine in much the same way that toothpaste is squeezed from the tube.

Constrictions. Rhythmic segmental movements produce local constrictions

of the intestine that mix the chyme with the digestive juices, and help to
propel food through the intestine.
ACTIVITIES OF THE LARGE INTESTINE
The activities of the large intestine are food breakdown and absorption and
defecation.

Food Breakdown and Absorption

What is finally delivered to the large intestine contains few nutrients, but tha
residue still has 12 to 24 hours more to spend there.
Metabolism. The “resident” bacteria that live in its lumen metabolize some of
the remaining nutrients, releasing gases (methane and hydrogen sulfide) that
contribute to the odor of feces.
Flatus. About 50 ml of gas (flatus) is produced each day, much more when
certain carbohydrate-rich foods are eaten.
Absorption. Absorption by the large intestine is limited to the absorption of
vitamin K, some B vitamins, some ions, and most of the remaining water.
Feces. Feces, the more or less solid product delivered to the rectum, contains
undigested food residues, mucus, millions of bacteria, and just enough water
to allow their smooth passage.
PROPULSION OF THE RESIDUE AND DEFECATION
When presented with residue, the colon becomes mobile, but its contractions are
sluggish or short-lived.

Haustral contractions. The movements most seen in the colon are haustral
contractions, slow segmenting movements lasting about one minute that
occur every 30 minutes or so.

Propulsion. As the haustrum fills with food residue, the distension stimulates
its muscle to contract, which propels the luminal contents into the next
haustrum.

Mass movements. Mass movements are long, slow-moving, but powerful

contractile waves that move over large areas of the colon three or four times
daily and force the contents toward the rectum.
PROPULSION OF THE RESIDUE AND DEFECATION

Rectum. The rectum is generally empty, but when feces

are forced into it by mass movements and its wall is
stretched, the defecation reflex is initiated.
Defecation reflex. The defecation reflex is a spinal (sacral
region) reflex that causes the walls of the sigmoid colon
and the rectum to contract and anal sphincters to relax.
Impluses. As the feces is forced into the anal canal,
messages reach the brain giving us time to make a
decision as to whether the external voluntary sphincter
should remain open or be constricted to stop passage of
feces.
Relaxation. Within a few seconds, the reflex contractions
end and rectal walls relax; with the next mass movement,
the defecation reflex is initiated again.
 GASTROINTESTINAL
DISEASES AND DISORDERS
GASTROINTESTINAL DISEASES AND DISORDERS
GERD (GASTROESOPHAGEAL REFLUX DISEASE,
OR CHRONIC ACID REFLUX)

GERD (gastroesophageal reflux disease,

or chronic acid reflux) is a condition in
which acid-containing contents in your
stomach frequently leak back up into
your esophagus.
GALLSTONES

Gallstones are small pieces of solid material

formed from digestive fluid that form in your
gallbladder, a small organ under your liver.
CONSTIPATION

Constipation generally happens when you go

poop (have a bowel movement) less
frequently than you normally do. When you’re
constipated, your poop is often dry and hard
and it’s difficult and painful for your poop to
pass
DIARRHEA

Diarrhea is when you have loose or

watery poop. Diarrhea can be
caused by many things, including
bacteria, but sometimes the cause
is unknown.
 CANCER
Cancers that affect tissues and organs in the
digestive system.

There are multiple kinds of GI cancers. The

most common digestive system cancers
include;
esophageal cancer
gastric (stomach) cancer, colon and rectal
(colorectal) cancer
pancreatic cancer
liver cancer
 CAUSES
Factors influencing genetic changes in cells of the
stomach include:
Gastro-esophageal reflux disease (GERD) or
backflow of stomach contents into the esophagus
Family history
Smoking
Obesity
Increased intake of smoked and salted food
Reduced intake of fruits and vegetables
Helicobacter pylori infection
Eating food contaminated by fungal toxin, especially
aflatoxin
Stomach polyps
Pernicious anemia resulting from poor absorption of
vitamin B12 by the intestines
Alcohol abuse
ESOPHAGEAL CANCER

h
 ESOPHAGEAL CANCER SYMPTOMS

DIFFICULTY SWALLOWING (DYSPHAGIA)

UNINTENTIONAL WEIGHT LOSS
CHEST PAIN, PRESSURE, OR BURNING
WORSENING INDIGESTION OR HEARTBURN
COUGHING OR HOARSENESS
EARLY ESOPHAGEAL CANCER MAY NOT
CAUSE NOTICEABLE SIGNS OR SYMPTOMS.
ESOPHAGEAL CANCER RISK FACTORS

BARRETT’S ESOPHAGUS: A PRECANCEROUS CONDITION

CAUSED BY CHRONIC ACID REFLUX INCREASES THE
RISK.
GASTROESOPHAGEAL REFLUX DISEASE (GERD)
SMOKING
OBESITY
ALCOHOL CONSUMPTION
UNDERGOING RADIATION THERAPY
COLORECTAL CANCER
 COLORECTAL CANCER SYMPTOMS
DIARRHEA
CONSTIPATION
BLOOD IN THE STOOL
FATIGUE
UNEXPLAINED WEIGHT LOSS
ABDOMINAL PAIN
BLOATING
HOWEVER, MANY PEOPLE MAY NOT HAVE
SYMPTOMS IN THE EARLY STAGES.
COLORECTAL CANCER RISK FACTORS

HIGH INTAKE OF PROCESSED MEATS AND LOW INTAKE

OF FRUITS AND VEGETABLES
SEDENTARY LIFESTYLE
OBESITY
SMOKING
EXCESSIVE ALCOHOL CONSUMPTION
PANCREATIC CANCER
PANCREATIC CANCER RISK FACTORS

SMOKING.
FAMILY HISTORY OF PANCREATIC CANCER.
OBESITY.
HEAVY ALCOHOL CONSUMPTION.
DIABETES.
EXPOSURE TO PESTICIDES AND CHEMICALS.
CHRONIC INFLAMMATION OF THE PANCREAS.
LIVER DAMAGE.
LIVER CANCER
 TYPES OF LIVER CANCER
HEPATOCELLULAR CARCINOMA (HCC): THIS IS THE MOST
COMMON TYPE OF LIVER CANCER AND BEGINS IN THE MAIN
LIVER CELLS (HEPATOCYTES).
INTRAHEPATIC CHOLANGIOCARCINOMA: A LESS COMMON
TYPE THAT ORIGINATES IN THE BILE DUCTS WITHIN THE
LIVER.
HEPATOBLASTOMA: RARE AND TYPICALLY AFFECTS
CHILDREN.
METASTATIC LIVER CANCER: WHEN CANCER SPREADS TO THE
LIVER FROM OTHER PARTS OF THE BODY.
 LIVER CANCER SYMPTOMS
UNINTENTIONAL WEIGHT LOSS
LOSS OF APPETITE
UPPER ABDOMINAL PAIN
NAUSEA AND VOMITING
GENERAL WEAKNESS AND FATIGUE
ABDOMINAL SWELLING
YELLOW DISCOLORATION OF THE SKIN AND EYES
(JAUNDICE)
PALE, CHALKY STOOLS
 LIVER CANCER RISK FACTORS

DNA MUTATIONS: LIVER CANCER OCCURS WHEN LIVER

CELLS UNDERGO MUTATIONS IN THEIR DNA, LEADING
TO UNCONTROLLED GROWTH AND TUMOR FORMATION.
CHRONIC INFECTIONS WITH HEPATITIS B VIRUS (HBV)
OR HEPATITIS C VIRUS (HCV) INCREASE THE RISK.
CIRRHOSIS: THIS IRREVERSIBLE LIVER CONDITION,
CHARACTERIZED BY SCAR TISSUE FORMATION, ALSO
RAISES THE RISK OF LIVER CANCER.
 DIAGNOSIS
LIVER FUNCTION TESTS BLOOD TESTS TO DETECT
SPECIFIC MARKERS LIKE ALFA-FETOPROTEIN AND
DES-GAMMA-CARBOXY PROTHROMBIN.
IMAGING TESTS: ULTRASOUND, CT SCAN, AND MRI TO
VISUALIZE THE LIVER AND IDENTIFY TUMORS.
LIVER BIOPSY: TISSUE SAMPLING TO DETERMINE IF
CELLS ARE CANCEROUS.
 TREATMENT
MEDICATION INTAKE: CHEMOTHERAPY DRUGS LIKE DOXORUBICIN, 5-
FLUOROURACIL, AND CISPLATIN.
MEDICAL PROCEDURES: TECHNIQUES LIKE CRYOABLATION, RADIOABLATION,
AND PERCUTANEOUS ETHANOL INJECTION TO DESTROY CANCER CELLS.
SURGERY: OPTIONS INCLUDE HEPATECTOMY (REMOVING PART OF THE LIVER)
AND LIVER TRANSPLANTATION.
RADIATION THERAPY: HIGH-ENERGY X-RAYS AND PROTONS TO SHRINK
TUMORS.
HEALTHY LIFESTYLE: REDUCING ALCOHOL CONSUMPTION, MAINTAINING A
HEALTHY WEIGHT, AND GETTING VACCINATED AGAINST HEPATITIS B.
THANK YOU
FOR LISTENING